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Positive Childhood Experiences: Resilience and Recovery From Personality Disorder in Early Adulthood.

Andrew E. Skodol, MD; Donna S. Bender, PhD; Maria E. Pagano, PhD; M. Tracie Shea, PhD; Shirley Yen, PhD; Charles A. Sanislow, PhD; Carlos M. Grilo, PhD; Maria T. Daversa, PhD; Robert L. Stout, PhD; Mary C. Zanarini, EdD; Thomas H. McGlashan, MD; and John G. Gunderson, MD

Published: July 16, 2007

Article Abstract

Objective: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

Method: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from personality disorder were determined using survival and proportional hazard regression analyses.

Results: Positive achievement experiences and positive interpersonal relationships during childhood or adolescence were significantly associated with remission from avoidant and schizotypal personality disorders. The greater the number of positive experiences and the broader the developmental period they spanned, the better the prognosis of these personality disorders.

Conclusions: The prognosis of certain personality disorders is better in patients whose developmental histories include positive experiences. Early treatment designed to foster personal strengths and competencies and to develop interpersonal skills might benefit young patients diagnosed with personality disorders.

Volume: 68

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